Maternal and Child Health

Introduction

Microbes such as bacteria, living within the gastrointestinal tract are important for food digestion, protection from pathogens, and have recently been implicated in disease risk, including metabolic dysfunction and obesity. The “Developmental Origins of Health and Disease” (DOHaD), suggests that the embryo/fetus/neonate makes adaptations in response to early life signals, resulting in adjustments in biological systems that eventually change disease risk in adulthood. Thus it is well established that a relationship exists between the early embryonic, fetal and early infant phases of life and the development of non communicable diseases, and now bacteria are proposed to mediate this relationship. In fact, the bacteria that live within the maternal gastrointestinal tract are known to change over the course of pregnancy, and changes in bacterial populations have been implicated in the metabolic adaptations that permit the mother to provide nutrients to the growing fetus. We think that these bacteria may facilitate nutritional communication between the mother, the placenta and the fetus, as well as modulate the development of the fetal gastrointestinal tract. Indeed, the establishment of the neonatal microbiome, once thought to be entirely postnatal, may in fact be primed in utero. The impact of the perinatal environment on the maternal and developing fetal/neonatal gut microbial – immune system are topics that are only now beginning to shed light on the early establishment of gut health and its relationship to postnatal disease risk. Bacteria interact intimately with the body in the first years of life and are responsible for educating the immune system about how to react appropriately. What species of bacteria colonize the body and how the communities change over time as people age is not fully understood. Nor is the impact that early life events such as maternal health and nutrition during pregnancy, antibiotic exposure, birth method or child nutrition have on bacterial community structure long term. Pregnancy is an opportunity to inform women who are invested in the well being of their children, about the benefits of maintaining a healthy lifestyle. Knowing risks could lead to maternal behavior change that may confer health benefits to the child, and into subsequent pregnancies. Our research studies aim to investigate host-microbial relationships – the nutritional and bacterial triggers of maternal immune and metabolic adaptations during pregnancy, and their impacts on fetal-placental development and offspring disease risk. We aim to describe critical early life events that shape how infants become colonized by commensal bacteria and how these differences in microbial colonization might impact the risk of non communicable diseases later in life. Through these investigations we can describe the factors that affect early colonization patterns as well as identify steps in development when interventions may impact the microbiota the most, so that we can inform new approaches to identifying, preventing and reducing multigenerational disease transmittance.